Health cuts correspondence with the UK

Summary

The requester asked for correspondence between Manx Care and off-island providers regarding the cancellation of funding for certain procedures. Manx Care released 15 documents totaling 143 pages but redacted personal names and email addresses under data protection exemptions.

Key Facts

• Manx Care is predicting an overspend for the current financial year due to a fixed budget and increased costs.
• The Isle of Man Government challenged Manx Care to reduce the overspend to protect the island's overall financial stability.
• Manx Care requested Liverpool Heart & Chest Hospital (LHCH) to slow down planned activity for the remainder of the financial year.
• Personal data such as names not in the public domain and email addresses were withheld from the released documents.
• The response included a draft letter from Oliver Radford to Teresa Cope regarding the request to LHCH.

Data Disclosed

• 2025-02-03
• 2025-03-05
• 23 February 2025
• 23 January 2025
• 143 pages
• 15 documents
• 4416389
• s25(b)(i)&(ii)
• Article 5
• Article 6
• Article 9

Exemptions Cited

• s25(b)(i)&(ii) of the Act (absolutely exempt personal information)
• Data Protection (Application of GDPR) Order 2018
• Article 5 of the General Data Protection Regulation

Original Request

Please provide copies of any correspondence between Manx Care and off Island providers in respect of the decision to cancel funding for certain procedures, as recently announced to the press.

Data Tables (4)

Full Response Text

Manx Care Noble’s Hospital, Strang Braddan, Isle of Man IM4 4R (01624) 650 000

Our ref: 4416389 5 March 2025

Dear

We write further to your request, received 3 February 2025, which states:

"Please provide copies of any correspondence between Manx Care and off Island providers in respect of the decision to cancel funding for certain procedures, as recently announced to the press."

Response

Please find enclosed copies of the information that is being released to you.

While our aim is to provide information whenever possible, in this instance we are unable to provide the information you have requested in relation to names not in the public domain and also email addresses in the information you have requested because it is absolutely exempt under s25(b)(i)&(ii) of the Act (absolutely exempt personal information).
The reasons why that exemption applies are that: · Manx Care is satisfied that the information amounts to personal data of which you are not the data subject; and · Manx Care is satisfied that disclosure of the information would contravene one of the data protection principles as set out at Article 5 of the General Data Protection Regulation as it applies in the Isle of Man pursuant to the Data Protection (Application of GDPR) Order 2018, namely that Manx Care can only disclose the information where it would be fair, lawful and meet one of the conditions for lawful processing in Article 6 [or if you are dealing with sensitive personal data “and one of the conditions in Article 9 of the GDPR and Schedule 2 of the Implementing Regulations is met”] and in this case, none of those conditions have been met, i.e. names not in the public domain and email addresses.

Please quote the reference number 4416389 in any future communications.

Your right to request a review

If you are unhappy with this response to your freedom of information request, you may ask us to carry out an internal review of the response, by completing a complaint form and submitting it electronically or by delivery/post.

An electronic version of our complaint form can be found by going to our website at https://services.gov.im/freedom-of-information/Review . If you would like a paper version of our complaint form to be sent to you by post, please contact me and I will

be happy to arrange for this. Your review request should explain why you are dissatisfied with this response, and should be made as soon as practicable. We will respond as soon as the review has been concluded.

If you are not satisfied with the result of the review, you then have the right to appeal to the Information Commissioner for a decision on; 1. Whether we have responded to your request for information in accordance with Part 2 of the Freedom of Information Act 2015; or 2. Whether we are justified in refusing to give you the information requested.
In response to an application for review, the Information Commissioner may, at any time, attempt to resolve a matter by negotiation, conciliation, mediation or another form of alternative dispute resolution and will have regard to any outcome of this in making any subsequent decision. More detailed information on your right to a review can be found on the Information Commissioner’s website at www.inforights.im. Should you have any queries concerning this letter, please do not hesitate to contact me. Further information about freedom of information requests can be found at www.gov.im/foi.

I will now close your request as of this date.

Yours sincerely

From: Cope, Teresa

Sent: 23 February 2025 17:16 To:

Subject: FW: Draft Letter to Liz Bishop @ LHCH

From: Radford, Oliver

Sent: 23 January 2025 08:59 To: Cope, Teresa Teresa.Cope@gov.im Cc:

Subject: Draft Letter to Liz Bishop @ LHCH

Hi Teresa

Further to yesterday’s request from , COO @ LHCH, I have drafted a letter for you to send to Liz Bishop just clarifying our request (which is basically what I sent over to on Tuesday). Do you mind reviewing and if ok, to top and tail and send over?

Dear Liz

Further to recent correspondence regarding Manx Care’s request to slow down planned activity at Liverpool Heart & Chest Hospital for the remainder of this financial year, I would like to confirm our request. Firstly I would like to provide some context to our ask – Manx Care is provided with a fixed budget at the beginning of the financial year and has almost no ability to supplement our budget to mitigate increases in expenditure such as individual high cost patients/placements, introduction of new drugs/therapies/vaccination programmes and higher than predicted areas of growth. As a result of a combination of these factors, Manx Care is predicting an overspend this year. The Isle of Man Government has challenged us to reduce the overspend as it impacts on the island’s overall financial stability, given the proportion of the overall government expenditure going on health and care, hence the rather drastic action we are taking across all our tertiary providers as well as curtailing planned activity on island. I am aware of the significantly improved working relationship between Manx Care and LHCH which has been nurtured by and locally by Oliver Radford, our Exec Director of Health Services and our respective clinical and operational teams, the pinnacle being launching a Primary PCI pathway for patients who suffer ST elevation MI on the Isle of Man.

In terms of our request around planned activity taking place in LHCH, this is:

We are requesting the following:

• LHCH to defer elective procedures/treatments as outlined in the email sent to by Oliver Radford on the 10th January @ 13.24 however this should also include deferring patients with a TCI date after the 1st February until after the 1st April 2025 that are classified as P4, unless there is a clinical imperative not to defer
• LHCH to defer routine new and non-time critical follow up outpatient appointments that are scheduled to occur between 1st February and 31st March. Please could follow up appointments be reviewed to see whether the patient could be discharged back to GP or local cardiology department or provided with an option for patient initiated follow up.

In addition, would it be possible to provide the outpatients and inpatient PTLs on a weekly basis and an activity report showing the previous week’s Isle of Man activity undertaken as well as the present week’s planned activity so we can accurately model our likely expenditure with LHCH in real time (such is the pressure on budget and the need to accurately forecast).

I appreciate this request will result in additional work for your administrative and clinical teams in terms of cancelling and rebooking patients and additional clinical reviews. If there needs to be further operational discussion around deliverability of our ask, please contact Oliver Radford directly.

Kind Regards….

CC: Oliver Radford

            Pete Shanahan  
            Kurt De Freitas 
            Tammy Hewitt

Thanks Oliver

Oliver Radford Executive Director of Health Services

Management Suite • Noble’s Hospital • Strang Braddan • Isle of Man • IM4 4RJ

E: • www.manxcar e.im

From:

To:

Sent: Mon Jan 20 2025 14:55:01 GMT Subject: RE: Notice to Trusts

Kurt

Can you send this please

Thanks

Pete

From: De Freitas, Kurt

Sent: 16 January 2025 16:44 To: Shanahan, Pete ; Lawless, Jackie (Manx Care)

; Cope, Teresa

Cc: Parry, Ashley Huckstep, Alistair ; Faragher, Theresa ; Rea, Lisa

Subject: Notice to Trusts Importance: High

Dear Pete See draft email. Does this comply with your instruction given in the Tertiary Forecasting Meeting today? Kind regards Kurt

Dear XYZ,

Following instructions from Pete Shanahan, Director for Financial Recovery at Manx Care, I am writing to advise you of the following:

Due to our current financial situation, please do not carry out any activity on Isle of Man patients between 20th January and 31st March 2025 that is not classified as P1.

If you do, we will not be in a position to pay the corresponding invoice.

Please ensure your services are informed and take the necessary steps to comply with this directive.

Should you have any questions, please feel free to reach out to Pete Shanahan or Oliver Radford, cc’d in.

Kind regards,

-----Original Appointment----- From: Parry, Ashley

Sent: 15 January 2025 11:34 To: Parry, Ashley; Huckstep, Alistair; Faragher, Theresa; De Freitas, Kurt; Shanahan, Pete; Lawless, Jackie (Manx Care);

Subject: Tertiary Forecast When: 16 January 2025 15:00-16:00 (UTC+00:00) Dublin, Edinburgh, Lisbon, London. Where: Microsoft Teams Meeting

Hi all

To go through Al’s workings for potential Tertiary forecast in time for Monday’s flash report to the DHSC

Microsoft Teams Need help?
Join the meeting now
Meeting ID: 391 542 399 747
Passcode: bh3Eq6wg

For organisers: Meeting options

From: Cope, Teresa

Sent: 23 February 2025 18:06 To:

Subject: FW: Formal Notice to Delay Isle of Man Activity - AHH

From: Radford, Oliver

Sent: 21 January 2025 14:47 To: Wadeson Gary

Cc: Cope, Teresa ; Shanahan, Pete

; De Freitas, Kurt

Subject: RE: Formal Notice to Delay Isle of Man Activity - AHH

Dear Gary,

Following up on your email and the concerns raised, I provide additional clarification to address your points, particularly regarding having enough notice to inform patients. I apologise for any confusion.

We are requesting the following:

• * Alder Hey to defer elective procedures/treatments with a TCI date after the 1st February who are graded P2/3/4 (or equivalent as there is a few priority codes within the PTL) which are NOT time-critical or cancer-related as determined by AHH.
• * Alder Hey to defer routine new and non-time critical follow up outpatient appointments that are scheduled to occur between 1st February and 31st March. Please could follow up appointments be reviewed to see whether the patient could be discharged back to GP or provided with an option for patient initiated follow up. Ongoing treatments such as patients on cancer pathways or receiving regular treatment (such as Dialysis) should not be affected.
• * Provide an activity report of the prior week’s activity by end of day each Thursday, on a weekly basis.

We will shortly communicate the decision to the local population. Any patient inquiries to your booking teams can be attributed to Manx Care’s decision to delay this activity. For further patient concerns, please direct them to our MCALS service (link).

Thank you for your understanding and cooperation. Please let me know if further clarification is needed.

Oliver

Oliver Radford Executive Director of Health Services

Management Suite • Noble’s Hospital • Strang Braddan • Isle of Man • IM4 4RJ

E: • www.manxcar e.im

From: Wadeson Gary

Sent: 21 January 2025 08:29 To: Shanahan, Pete ; De Freitas, Kurt

Cc: Radford, Oliver ; Cope, Teresa

Subject: RE: Formal Notice to Delay Isle of Man Activity - AHH

Caution: This email is from an external sender. Please take care before opening any attachments or following any links.
Hi all

Please let me know how you want us to proceed.

I haven’t instructed cancellations as yet.

Thanks

Gary

Gary Wadeson
Associate Director – Income, Costing & Commissioning
Alder Hey Children’s NHS Foundation Trust

Email:

                            Inspired by Children

From: Wadeson Gary
Sent: 20 January 2025 17:48 To: Shanahan, Pete ; De Freitas, Kurt

Cc: Radford, Oliver

; Cope, Teresa

Subject: RE: Formal Notice to Delay Isle of Man Activity - AHH

Hi all

Please see attached; not in the format you wanted, but given the haste I thought send you the full dataset.

These are elective patients. The report excludes emergency patients (who are generally P1).

Two tabs: inpatients and outpatients.

Not all patients have a P code, but it can be assumed they will, by definition, not be P1.

You will see a good proportion of patient have an attendance date or a TCI already.

Any questions let me know.

Thanks

Gary

Gary Wadeson
Associate Director – Income, Costing & Commissioning
Alder Hey Children’s NHS Foundation Trust

Email:

                            Inspired by Children

From: Shanahan, Pete

Sent: 20 January 2025 16:45 To: Wadeson Gary ; De Freitas, Kurt

Cc: Radford, Oliver ; Cope, Teresa

Subject: RE: Formal Notice to Delay Isle of Man Activity - AHH

Gary

I understand your point

I'm not aware you have supplied the requested PTL - which would help inform a nuanced position

Sent from Workspace ONE Boxer

On 20 Jan 2025 16:38, Wadeson Gary

wrote:
Caution: This email is from an external sender. Please take care before opening any attachments or following any links.
Hi Kurt

With respect, are you understanding of the implications of this?

There will be tens and tens of Isle of Man children (many here already), expecting surgery, dialysis, chemotherapy or outpatient attendances in the next few days.

P1 patients are emergency admissions.

Gary

Gary Wadeson
Associate Director – Income, Costing & Commissioning
Alder Hey Children’s NHS Foundation Trust

Email:

                            Inspired by Children

From: De Freitas, Kurt

Sent: 20 January 2025 16:19 To: Wadeson Gary

Cc: Radford, Oliver ; Shanahan, Pete

Cope, Teresa

Subject: Formal Notice to Delay Isle of Man Activity - AHH

Dear Gary,

Following instructions from Pete Shanahan, Director for Financial Recovery at Manx Care, I am writing to advise you of the following:

Due to our current financial situation, please do not carry out any activity on Isle of Man patients between now and 31st March 2025 that is not classified as P1.

If you do, we will not be in a position to pay the corresponding invoice.

Please ensure your services are informed and take the necessary steps to comply with this directive.

Should you have any questions, please feel free to reach out to Pete Shanahan or Oliver Radford, cc’d in.

Kind regards,

Kurt

Kurt De Freitas
Service Development Manager

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